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When Marie Kube admitted her father at the Dr. Cooke Nursing Home she expected that hospital staff would administer CPR (cardiopulmonary resuscitation) in case of an emergency.
However during a family meeting held every six months, Kube, herself a practical nurse of 37 years, says staff members informed her CPR is not administered there.
“When my dad was admitted there we were not informed that they do not do CPR and that just put me in a tailspin when we had a family meeting a couple of weeks ago [and discussed] that they do not administer CPR there,” she said.
Calls to the Doctor Cooke Nursing Home were directed to Joan Zimmer, director of continuing care for the Prairie North Regional Health Authority. Zimmer said there are indeed non-CPR facilities in North Battleford, but that is because the patients in those particular facilities are very frail and performing CPR could do more harm than good.
Zimmer added the staff at Dr. Cooke are trained in CPR and believes Kube got confused with the facility’s health directives, which include different levels of care administered to each resident depending on their medical condition.
For example Degree Two states:
“Supportive nursing care in the facility or at home, relief of pain, adequate oral fluids, fever control and symptom management. Therapeutic measures within the limits of the home or facility, including hydration for the purpose of administering pain relief or antibiotics. This does not include CPR.”
CPR, however, is included in Degree Four when the patient is on the way to acute care:
“Maximum life-saving effort including transport to acute care and for CPR on the way and in acute care. Stabilize in acute care, establish a prognosis and have further decisions made by myself (the relative) or my proxy in consultation with the medical team.”
Kube was also surprised to learn the facility is not equipped with AEDs (Automatic Electronic Defibrillators). The devices determine if the heart has stopped beating and, if so, delivers an electric shock to the heart. Kube is concerned that if the nursing home does not have AEDs, by the time emergency services are dispatched patients will have suffered permanent health damage.
Regarding AEDs, Zimmer said this is a discussion that needs to happen at a provincial level where they would analyze the cost of the devices and the training needed to operate them.
“Both regionally and provincially we would look at the benefits of having an AED in long-term care but as to this date we haven’t had that discussion.”
John Hein, coordinator for public access to defibrillation with Alberta Health Services, said the price for AEDs range from $1,200 to about $2,500, depending on where the device is used.
Training is recommended for the devices, but Hein said the instructions are not difficult to follow.
“The devices themselves have what we call Real Time Training. You turn the device on, there are voice prompts that will lead through to every step that you need to follow, including how to do CPR, prompting to call 911 services and then how to use the device itself.”
A handful of health-related businesses in Lloydminster have AEDs and in November 2012 AHS and the Heart and Stroke Foundation also gave one away to the Lloydminster Golf and Curling Centre as part of an initiative that started a year ago, where they gave 150 devices to communities throughout Alberta.
As to whether or not patients at nursing homes would be in greater danger because of the absence of the devices in case of an emergency such as a heart attack, Zimmer said the policy of the Dr. Cooke home is to initiate CPR and then call 911 emergency services, which should dispatch an ambulance in five to 10 minutes.
“If you’re going to initiate CPR you have to end up going to an acute care emergency room to have all the necessary treatments, physicians and staff to provide the care for someone that is requiring CPR,” Zimmer said. “They’re better equipped with the medications, the care plans, those sorts of things, so if we start to initiate CPR, we’d be calling 911 and they’d be transferred to the Lloyd Emergency Department.”
Despite Zimmer’s comments, Kube maintains staff members at the Dr. Cooke Nursing told her they do not perform CPR there and does not understand why the facility is not equipped with AEDs.
“Why do other places have the AEDs? I don’t understand why a nursing home wouldn’t have an AED in it and hockey arenas, resort areas, different places do,” she said.